The global distribution of acute unintentional pesticide poisoning: estimations based on a systematic review (original) (raw)
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Deaths from pesticide poisoning: a global response
British Journal of Psychiatry, 2006
SummarySelf-poisoning with pesticides accounts for about a third of all suicides worldwide. To tackle this problem, the World Health Organization announced a global public health initiative in the second half of 2005. Planned approaches were to range from government regulatory action to the development of new treatments for pesticide poisoning. With broad-based support, this strategy should have a major impact on the global burden of suicide.
The global distribution of fatal pesticide self-poisoning: systematic review
BMC public …, 2007
Background: Evidence is accumulating that pesticide self-poisoning is one of the most commonly used methods of suicide worldwide, but the magnitude of the problem and the global distribution of these deaths is unknown. Methods: We have systematically reviewed the worldwide literature to estimate the number of pesticide suicides in each of the World Health Organisation's six regions and the global burden of fatal self-poisoning with pesticides. We used the following data sources: Medline, EMBASE and psycINFO (1990-2007), papers cited in publications retrieved, the worldwide web (using Google) and our personal collections of papers and books. Our aim was to identify papers enabling us to estimate the proportion of a country's suicides due to pesticide self-poisoning. Results: We conservatively estimate that there are 258,234 (plausible range 233,997 to 325,907) deaths from pesticide self-poisoning worldwide each year, accounting for 30% (range 27% to 37%) of suicides globally. Official data from India probably underestimate the incidence of suicides; applying evidence-based corrections to India's official data, our estimate for world suicides using pesticides increases to 371,594 (range 347,357 to 439,267). The proportion of all suicides using pesticides varies from 4% in the European Region to over 50% in the Western Pacific Region but this proportion is not concordant with the volume of pesticides sold in each region; it is the pattern of pesticide use and the toxicity of the products, not the quantity used, that influences the likelihood they will be used in acts of fatal self-harm. Conclusion: Pesticide self-poisoning accounts for about one-third of the world's suicides. Epidemiological and toxicological data suggest that many of these deaths might be prevented if (a) the use of pesticides most toxic to humans was restricted, (b) pesticides could be safely stored in rural communities, and (c) the accessibility and quality of care for poisoning could be improved.
Acute Human Lethal Toxicity of Agricultural Pesticides: A Prospective Cohort Study
PLoS Medicine, 2010
Background: Agricultural pesticide poisoning is a major public health problem in the developing world, killing at least 250,000-370,000 people each year. Targeted pesticide restrictions in Sri Lanka over the last 20 years have reduced pesticide deaths by 50% without decreasing agricultural output. However, regulatory decisions have thus far not been based on the human toxicity of formulated agricultural pesticides but on the surrogate of rat toxicity using pure unformulated pesticides. We aimed to determine the relative human toxicity of formulated agricultural pesticides to improve the effectiveness of regulatory policy.
Pattern and Impact of Pesticide Poisoning: A Review of Published Case Reports
Texila International Journal of Public Health, 2024
Pesticides are essential in agriculture and public health, but their use is associated with many adverse health outcomes. The objective of the current study was to review published case reports to elucidate the pattern and health impacts of exposure to various pesticide classes, including organochlorines, organophosphates, carbamates, pyrethroids, organosulfur, botanicals, and biopesticides. We conducted a review of case reports focusing on the health effects of pesticide exposure across different chemical classes. Searches were performed in major scientific databases, and relevant articles were selected based on predetermined inclusion criteria. Data extraction and synthesis were carried out to identify common health outcomes associated with each pesticide class. Organochlorines, despite being largely phased out, still pose risks due to their persistence and bioaccumulation, with links to neurodegenerative diseases and cancer. Organophosphates, known for cholinergic overstimulation, can lead to respiratory distress and seizures. Carbamates, affecting cholinesterase activity, may cause respiratory paralysis and coma. Pyrethroids disrupt the nervous system and can induce convulsions and alter consciousness. Organosulfur can induce liver damage and renal dysfunction. Botanical pesticides and biopesticides, while generally considered safer, can also cause severe toxicity, including methemoglobinemia and multiorgan failure, as evidenced by rare cases of poisoning. This review highlights the diverse health impacts of pesticide exposure across different chemical classes. It exposes the need for systematic surveillance, longitudinal studies, and comparative assessments between conventional pesticides and biopesticides. Interdisciplinary collaborations are crucial for comprehensive risk assessment and the development of targeted interventions to mitigate these detrimental effects.
Journal of Nepal Medical Association
Introduction: Acute pesticide poisoning is a significant global public health issue that contributes to one of the leading causes of emergency department visits. There is no national data on the incidence of acute pesticide poisoning or the pesticides that cause deaths. The purpose of this study is to find the prevalence of pesticide poisoning among patients who presented to the emergency department with acute poisoning. Methods: This was a descriptive cross-sectional study undertaken in a tertiary care hospital from April to September 2021 among patients who presented to the emergency department with acute poisoning. Ethical clearance was obtained from (reference number: 123/2077-78). Convenient sampling was done. Sociodemographic factors, types of poison consumed, route of consumption, reason, motive, and place of poison intake, time elapse in the presentation to the hospital were studied along with psychological factors associated with poisoning. Statistical analysis was done usi...
Clinical Toxicology, 2004
Some years ago, we explicitly stated what most clinical toxicologists already knew -that it was not possible to practice 'evidence based medicine' in clinical toxicology.(1) This was simply because there was next to no evidence: the published data on treatment included very few randomised clinical trials (RCTs) addressing clinical end-points, observational studies of clinical features were lacking in both quantity and quality, and diagnostic and prognostic tests were not prospectively validated. As a result, knowledge and management of many forms of poisoning was based largely on case reports and clinicians relied on textbooks of expert opinion for guidance. We suggested that the solution was to collect prospective data and to apply the tools of clinical epidemiology to better describe the natural history of poisonings, identify high-risk individuals, and determine the effects of treatment and the relative toxicity of drugs within therapeutic classes.(2;3) There has subsequently been a major shift in the methods of evaluating evidence in the toxicology community.(4;5) However, we believe that too little evidence is still being generated where it is most required.
Revista Facultad Nacional de Salud Pública, 2023
Objective: To analyze the behavior of pesticide poisoning in rural and urban populations associated with lethality in Colombia during 2007-2017. Methodology: Retrospective observational study that included: a descriptive cross-sectional study and an ecological design that analyzed aggregate measures of morbidity, mortality and risk attributable to the population in rural and urban areas. In the cross-sectional study, the relative risk was estimated to measure the factors associated with lethality among intoxications using Poisson regression with logarithmic function. For the time series, the trends were established with simple linear regression and the seasonal decomposition was performed using the multiplicative model. Autocorrelations were tested using the Box-Ljung statistic. Results: Between 2007-2017; 89 490 cases were reported. The Morbidity due to poisoning showed a higher proportion in the rural population 36.03 cases per 100 000; this indicator was three times higher than in urban areas (12,33 cases per 100 000). The mortality rates in rural and urban areas were 1,00 and 0,13 cases per 100 000, respectively. The relative risk of fatality in case of intoxication was associated with the intention of suicide in the rural population RR: 5.9 (95% CI: 5.0-6.9). Conclusion: A higher proportion of lethality associated with these events occurred in populations living in rural areas and reporting cases of suicidal intent. In addition, morbidity and mortality due to pesticide poisoning had the highest proportion in rural areas and a growing trend over time.